Commercial Building Permit Applications Commercial Permit Applications February 1, 2013
TABLE OF CONTENTS Building Permit Application 3 Temporary Electrical Service Request Application.. 4 Subcontractor Affidavit 5 Commercial Plan Review Submittal Form 6 Authorized Permit Agent Form... 7
Permit Number: CITY OF PEACHTREE CORNERS COMMERCIAL BUILDING PERMIT APPLICATION Fee: Application is hereby made according to the laws and ordinances of the City of Peachtree Corners, Georgia for a permit to construct and use a building or structure as described herein and shown on City code compliance reviewed plans and specifications and to be located as shown on the accompanying City reviewed plat plan and, if same is granted by the City, I/we agree to conform to all laws and ordinances regulating same. ALL APPLICABLE BLANKS MUST BE FILLED IN NO P.O. BOX ADDRESSES PLEASE PRINT LEGIBLY Application Date: Applicant is: Owner / Agent Contractor / Agent New Building / Structure Addition Shell Interior Finish Foundation Only Site Wall Pre-Engineered Buildings (Construction Trailers etc.) Re-Roof Racking System City LDP No: Sewer Permit No: PROPERTY INFORMATION Project Street Address: Suite: City Zoning District: Land Lot: District: Section: Front Setback: ft. Left Side Setback: ft. Right Side Setback: ft. Rear Setback: ft. Flood Plain Lot Lower Floor Elevation: MSL Note: FEMA Elevation Letter Required Prior to CO. PEOPLE INFORMATION Property Owner: Tel. No: ( ) Street Address: E-Mail: City: State: Zip: Contractor: Tel. No: ( ) Street Address: E-Mail: City: State: Zip: Business Registration No: Where Issued: Expires: Tenant Name: Email: Tel. No: WORK INFORMATION Project Name: Briefly Describe Work: Building Height: ft. No. Stories: Fire Sprinkled: Y N Max Live Load / FL psf. Foundation is: Slab-on-Grade Crawlspace Basement Other: Associated Work? Mechanical Electrical Plumbing Low Voltage Grease Trap Primary Use Group: Use: Type of Const: 1A 1B 2A 2B 3A 3B 4 5A 5B Total Construction Valuation: Applicant Printed Name: Applicant Signature: Date: OFFICE USE ONLY Building Official Approval: Date: Conditions of Approval:
CITY OF PEACHTREE CORNERS TEMPORARY ELECTRICAL SERVICE REQUEST APPLICATION Request for temporary approval of electric service conductors and service switch Date: Building Permit Number: Project: Suite: Project Address: Number of day s temp service requested: Utility Provider: This system is requested for machinery and equipment testing 1. The general contractor thereby assumes all responsibility for any use of electricity in the structure during the temporary period. Any extension of the temporary approval shall be thru re-application submittal. 2. This Temporary Conditional Electric Service is being given as a convenience for the Contractor / Permit Holder. Violation, such as any unapproved occupancy or use of power for other purposes than being requested, will be considered sufficient cause for the power to be terminated, as well as denial of future request for Temporary Power by the Contractor / Permit Holder. The City of Peachtree Corners also reserves the right to have the temporary power removed at any time it feels that the safety of workers or any other persons may be in danger due to the Temporary Electrical Power. Contractors Statement: I / We relieve the City of Peachtree Corners and its employees from any and all liability for damages or loss due to the temporary electrical service approval. Date: Signed by: Printed Name: Company Name: Address: Electrical Contractors Statement: The service equipment for which approval is being applied for has been installed in accordance with applicable codes and is ready for inspection. Date: Company Name: Electrical Contractor Printed Name: Electrical Contractor Signature: Card #: Class: Expiration:
CITY OF PEACHTREE CORNERS SUBCONTRACTOR AFFIDAVIT A subcontractor affidavit is required for each building permit BUILDING PERMIT NUMBER: DATE: SUBDIVISION: LOT: BLOCK: JOB SITE ADDRESS: GENERAL CONTRACTOR: This is to certify that I am responsible for the: (PLEASE CHECK) Electrical Plumbing Water Services Only Heat/Air Grease Hood Duct Work Refrigeration System Gas Piping Mobile Home Installation Sewer Line Connection Septic Line Connection Sewer Lateral Only Septic Tank Only Electrical Contractor Class I (Restricted to Single-Phase, not exceeding 200 Amps at service drop or lateral) Electrical Contractor Class II (Unrestricted) Low-Voltage Contractor Class LV-A (Restricted to Alarm & General System Low Voltage) Low-Voltage Contractor Class LV-G (Restricted to General System Low Voltage) Low-Voltage Contractor Class LV-T (Restricted to Telecommunication & General System Low Voltage Low-Voltage Contractor Class LV-U (Unrestricted) Master Plumber Class I (Restricted to S/F, 1 level Duplex & Commercial up to 10,000 sq. ft.) (*See Note below) Master Plumber Class II (Unrestricted) Utility Contractor Septic (Septic Tank GA-TC) Conditioned Air Contractor Class I (Restricted to 60,000 BTU Cooling 175,000 BTU Heating per unit) Condition Air Contractor Class II (Unrestricted) Mobile/Manufactured Home Installer NOTE: This affidavit for Sewer/Septic Line Connection is acceptable in lieu of inspections ONLY for the following: One & Two Family Dwellings, Duplexes, Triplexes, Quadraplexes, Townhouses & Condominiums. I certify that I will comply with all codes and ordinances adopted by The City of Peachtree Corners that pertain to the construction of this structure. In the event of any change in my status on this installation, I understand that I will be held responsible for all indicated work at this job until Building Inspections has been notified, in writing, of any change. I understand that it is my responsibility to insure that the sewer or septic line connection shall be installed in accordance with the Georgia State Plumbing Code and ordinances adopted by the City of Peachtree Corners. I hereby agree to indemnify the City of Peachtree Corners and its inspectors from any liability for damages and loss of property if the sewer or septic line connection has not been installed in accordance with these codes and ordinances. SIGNATURE: PLEASE PRINT NAME: COMPANY STREET ADDRESS: CITY: STATE: ZIP: BUSINESS PHONE: CELL: Construction Valuation for stand-alone permits:
Commercial Plan Review Submittal Form To help save time when submitting plans for building and fire plan review, city officials have developed this form for your use. Please fill in all blanks and check all appropriate boxes for each planned construction project. Project Type? New Const. Addition Interior Finish Demolition Site Wall Project Name: Project Street Address: Contact Person to receive review comments, if other than Project Architect contact person: Name: Tel: Email: Contact Person Street Address: Applicant Name: Tel: Email: Y N N/A Pre-approval by other authority, if required? County Sewer/Health, etc.? Completed and signed City building permit application form included? One page Site Plan or Key / Location Plan included? Title Page included showing at least the following information applicable for work to be done? Site street address to include suite / building number? Project size, type & brief use description? Schedule of occupancy use? Room by room egress occupant load calculations? - NFPA 101 Table 7.3.1.2. Egress width calculations? - NFPA 101 Section 7.3.3.1. Building construction type and fire protection information? Building height and area modification calculations? Applicable only to new building or addition. Listing of effective codes for design and construction? Property owner s name, street address, contact person, telephone number and e-mail address? All designers names, street address, contact person, telephone number and e-mail address? Plan page index listing all plan pages included in the submittal? Complete architectural plans included and match plan page index? Complete structural plans included and match plan page index? Complete mechanical plans included and match plan page index? Complete electrical plans included and match plan page index? Complete low voltage plans included and match plan page index? Complete plumbing plans included and match plan page index? Complete fire protection plans included and match plan page index? Structural Design Summary included for all new structures and additions to existing structures? Georgia Energy Code Compliance Report included for all new buildings and adds to existing buildings? Comments: Building Official Signature: Date:
State Licensing Board for Residential and General Contractors Authorized Permit Agent Form License verification by permitting office should be completed by visiting sos.ga.gov/plb/ Licensed Contractor: Individual Qualifying Agent Name of licensed person *Please attach a copy of Individual license or Company License (Reflects Company and qualifying agent license number) License number of individual or qualifying agent: Name of licensed company (if applicable) License number of company (if applicable): I,, hereby designate Licensed Individual or Qualifying Agent to apply for and obtain the permit(s) for the *Please attach a copy of the authorized permit agent s driver s license. project at: Street address Apartment or Suite Number City Zip Code I, the undersigned, being the contractor as either an individual or a qualifying agent, do hereby affirm and swear, under oath, that all information on this form and on accompanying documents is true and correct. Signature of individual or qualifying agent State of County of Subscribed and sworn to before me this day of 20 Signature of Notary Public (Seal)